The role of goal adjustment in symptoms of depression, anxiety and fatigue in cancer patients receiving psychosocial care:A longitudinal study

Objective: This study examined whether cancer patients reported increases in their goal adjustment capacities while receiving psychosocial care and whether these increases were related to changes in symptoms of depression, anxiety and fatigue. Goal adjustment was conceptualised as two independent capacities: goal disengagement (i.e. disengage from unattainable goals) and goal reengagement (i.e. reengage into new goals). Design: This naturalistic, longitudinal study focused on 241 cancer patients receiving psychosocial care at one of the seven psycho-oncology institutions in the Netherlands. Data was collected before the start of psychosocial care (T1) and nine months thereafter (T2). Hierarchical regression analysis was used to examine the research questions. Main Outcome Measures: Goal adjustment, symptoms of depression, anxiety and fatigue. Results: At group level, patients reported small increases in goal disengagement (d=.22) but no significant change in goal reengagement (d=.09). At an individual level, 34% of cancer patients reported an increase in goal disengagement and 30% reported an increase in goal reengagement. Increases in goal reengagement were significantly associated with decreases in both depressive and anxiety symptoms, but not to changes in fatigue. Conclusion: Findings indicate that particularly improvements in goal reengagement are beneficial for cancer patients' psychological functioning.